男性肾移植受者的睾酮水平与其他因素与骨密度的关系：一项横断面研究。

Relation of testosterone level and other factors with bone mineral density in male kidney transplant recipients: a cross-sectional study.

机构信息

Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Clinical and Chemical Pathology Department, Faculty Of Medicine, Alexandria University, Alexandria, Egypt.

出版信息

BMC Nephrol. 2023 Sep 14;24(1):271. doi: 10.1186/s12882-023-03318-8.

DOI:10.1186/s12882-023-03318-8

PMID:37710199

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10502991/

Abstract

BACKGROUND

Although testosterone has a pivotal role in bone health, its correlation with bone mineral density (BMD) is understudied in kidney transplant recipients who are at high risk of osteoporosis. This study aimed to elucidate if there is any correlation between serum free testosterone and BMD in this population.

PATIENTS AND METHODS

Sixty male kidney transplant recipients were enrolled in this cross-sectional study, and they were subjected to history taking, clinical examination, and laboratory investigations (including total and free testosterone). BMD was assessed in three regions (forearm, hip, and lumbar spine) using DEXA scan.

RESULTS

The mean age of the included patients was 45.55 ± 13.58 years. Serum total and free testosterone had mean values of 5.17 ± 1.4 ng/ml and 95.46 ± 28.24 pg/ml, respectively, with all levels within the normal range. DEXA scan detected osteoporosis and osteopenia in 9 (15%) and 30 (50%) patients in the lumbar region, 3 (5%) and 36 (60%) in the hip region, as well as 21 (35%) and 33 (55%) in the forearm region, respectively. BMD of the lumbar region had a significant positive correlation with free testosterone, phosphorus, and eGFR, while it had a significant negative correlation with platelets and patient age. BMD of the hip region was positively correlated with serum phosphorus, parathyroid hormone, and duration since the transplant, whereas it was negatively correlated with platelets and total testosterone level. BMD of the forearm had a significant positive correlation with eGFR, whereas it had a significant negative correlation with age and duration since transplantation. In addition, forearm BMD was significantly lower in patients with a radiocephalic AVF.

CONCLUSION

Even within the normal range, free testosterone has a significant positive correlation with lumbar spine BMD with no significant association with the forearm or hip BMD.

摘要

背景

尽管睾酮在骨骼健康中起着关键作用，但在骨质疏松风险较高的肾移植受者中，其与骨密度（BMD）的相关性研究甚少。本研究旨在阐明该人群中血清游离睾酮与 BMD 是否存在相关性。

患者与方法

本横断面研究纳入了 60 名男性肾移植受者，对其进行了病史采集、临床检查和实验室检查（包括总睾酮和游离睾酮）。使用 DEXA 扫描评估了三个部位（前臂、髋部和腰椎）的 BMD。

结果

纳入患者的平均年龄为 45.55±13.58 岁。血清总睾酮和游离睾酮的平均值分别为 5.17±1.4ng/ml 和 95.46±28.24pg/ml，均处于正常值范围内。DEXA 扫描发现，腰椎、髋部和前臂区域的骨质疏松和骨量减少分别分别为 9（15%）和 30（50%）、3（5%）和 36（60%）以及 21（35%）和 33（55%）。腰椎 BMD 与游离睾酮、磷和 eGFR 呈显著正相关，与血小板和患者年龄呈显著负相关。髋部 BMD 与血清磷、甲状旁腺激素和移植后时间呈正相关，与血小板和总睾酮水平呈负相关。前臂 BMD 与 eGFR 呈显著正相关，与年龄和移植后时间呈显著负相关。此外，头臂静脉内瘘患者的前臂 BMD 显著较低。